93 Decision Citation: BVA 93-07446
Y93
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 92-09 740 ) DATE
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THE ISSUE
Entitlement to an increased rating for diabetes mellitus,
currently rated as 20 percent disabling.
ATTORNEY FOR THE BOARD
Marshall O. Potter, Jr., Associate Counsel
INTRODUCTION
The veteran had active service from May 1987 to August 1991.
This appeal is from a January 1992 decision by the Department
of Veterans Affairs (VA) Atlanta, Georgia, Regional Office
(RO) which granted the veteran service connection for
diabetes mellitus and assigned it a 20 percent evaluation.
The veteran submitted a notice of disagreement with that
evaluation in March 1992. He was provided with a statement
of the case later that month. In May 1992, he submitted a
substantive appeal. This case was received and docketed at
the Board of Veterans' Appeals (Board) in June 1992. The
veteran represents himself in this claim.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that he is entitled to a higher
evaluation because his diabetes mellitus requires that he
take insulin, diet and exercise. He asserts that his
activities are restricted and that he had to give up a job
as a financial consultant because of his diabetes mellitus.
DECISION OF THE BOARD
In accordance with the provisions of 38 U.S.C.A. § 7104
(West 1991), following review and consideration of all
evidence and material of record in the veteran's claims
file, and for the following reasons and bases, it is the
decision of the Board that the preponderance of the evidence
is against the claim for an evaluation in excess of
20 percent for the veteran's service-connected diabetes
mellitus.
FINDING OF FACT
The veteran's diabetes mellitus is no more than moderately
disabling.
CONCLUSION OF LAW
The schedular criteria for an evaluation in excess of
20 percent for diabetes mellitus have not been met.
38 U.S.C.A. §§ 1155, 5107(a) (West 1991); 38 C.F.R. §§ 4.1,
4.119, Diagnostic Code 7913 (1992).
REASONS AND BASES FOR FINDING AND CONCLUSION
The veteran's claim is well grounded within the meaning of
38 U.S.C.A. § 5107(a). That is, he has presented a claim
which is not inherently implausible. We are satisfied that
all relevant facts have been properly developed with regard
to the claim. No further assistance to the veteran is
required to comply with the duty to assist him. Id.
Disability evaluations are determined by the application of
a schedule of ratings which is based on average impairment
of earning capacity. 38 U.S.C.A. § 1155; 38 C.F.R. Part 4.
Separate diagnostic codes identify the various disabilities.
The appropriate criteria to be applied in the evaluation of
this claim is found in 38 C.F.R. § 4.119, Diagnostic Code
7913. Under this code, an evaluation of 20 percent will be
assigned where diabetes mellitus is moderate with moderate
insulin or oral hypoglycemic agent dosage and restricted
(maintenance) diet without impairment of health or vigor or
limitation of activity. For a 40 percent evaluation to be
assigned, the disability must be moderately severe and
require a large insulin dosage, restricted diet and careful
regulation of activities, that is, avoidance of strenuous
occupational and recreational activities.
In this case, the veteran's service medical records show
that in May 1990 he had an elevated fasting glucose
reading (183) and an assessment of diabetes mellitus was
made. At that time he reported a weight gain, that he ate
two meals a day and did not snack. He also reported
nocturia (excessive urination at night), Dorland's
Illustrated Medical Dictionary, 896 (26th ed. 1985) with no
polydipsia (excessive thirst), Dorland's Illustrated Medical
Dictionary, 1048, Id.) or polyphagia (excessive eating),
Dorland's Illustrated Medical Dictionary, 1050, Id. After
he had been on a diabetic diet for about three months, a
followup examination showed his fasting glucose reading to
have decreased (121) and he reported his nocturia had also
improved. The assessment continued to be diabetes mellitus.
At that time his weight was essentially the same. A physical
examination at the time of his separation from service,
apparently, was not conducted.
At a VA examination in October 1991, the veteran mentioned
intermittent numbness and tingling of the 4th and 5th digits
in the left hand. He reported no trouble with impotence.
He said that his weight had stabilized at about 215 pounds
after having lost 30 pounds while he was in Saudi Arabia.
On examination, he was observed to be 6 feet tall and to
weigh 215 pounds. His maximum weight reported for the
period of one year before the examination was 257 pounds.
An examination of the eyes showed no diabetic changes. An
endocrine examination was negative. His motor strength was
considered to be excellent. There were no sensory deficits.
He had good peripheral pulses throughout. However, a blood
glucose test showed his glucose to be 361 (average range was
considered to be between 70-110), and his urine glucose to
be three plus. This represents an increase in the glucose
readings observed during his military service. The diagnosis
was noninsulin-dependent diabetes mellitus.
In December 1991, E. W. Beasley, III, M.D., reported the
veteran was an insulin-dependent diabetic and had been
hospitalized for the control of that disability earlier that
month. The doctor said that the veteran was taking three
shots of insulin a day to control his blood sugars. The
doctor said the veteran's blood sugars were well controlled
on this regimen.
The veteran has stated that he takes 30 units of insulin a
day. (See substantive appeal submitted in May 1991). Given
the veteran's weight, that dosage is considered moderate or
average. 2 Cecil, Textbook of Medicine 1371, Id. Moreover,
the veteran has reported his glucose blood count is
controlled by insulin, diet and exercise. Thus, while the
veteran has to take daily dosages of insulin, and must diet
and exercise; his insulin dosage is not large which is one
of the requirements for the assignment of a 40 percent
rating. Additionally, there is no indication that his
diabetes, at this time, has resulted in his having to
"carefully" regulate his activities other than his diet and
exercise.
Although we have considered the veteran's assertions that
his service-connected diabetes mellitus caused him to give
up his job as a financial consultant because the stress of
that job caused his blood sugar to go out of control,
percentage evaluations to be assigned a service-connected
disability are determined by the average impairment in
earning capacity which ordinarily results from the
disability in question and not the actual impairment which
it causes the individual who has been service connected for
the disability. 38 C.F.R. § 4.1. In view of the current
extent of impairment associated with the veteran's diabetes
mellitus, we find his service-connected diabetes mellitus to
be no more than moderately disabling and the 20 percent
evaluation assigned to be correct.
ORDER
Entitlement to a disability evaluation of more than
20 percent for diabetes mellitus is denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
*
(MEMBER TEMPORARILY ABSENT) L. W. TOBIN
STEPHEN A. JONES
*38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of
Veterans' Appeals Section, upon direction of the Chairman of
the Board, to proceed with the transaction of business
without awaiting assignment of an additional Member to the
Section when the Section is composed of fewer than three
Members due to absence of a Member, vacancy on the Board or
inability of the Member assigned to the Section to serve on
the panel. The Chairman has directed that the Section
proceed with the transaction of business, including the
issuance of decisions, without awaiting the assignment of a
third Member.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting
less than the complete benefit, or benefits, sought on
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appeal is appealable to the United States Court of Veterans
Appeals within 120 days from the date of mailing of notice
of the decision, provided that a Notice of Disagreement
concerning an issue which was before the Board was filed
with the agency of original jurisdiction on or after
November 18, 1988. Veterans' Judicial Review Act, Pub. L.
No. 100-687, § 402 (1988). The date which appears on the
face of this decision constitutes the date of mailing and
the copy of this decision which you have received is your
notice of the action taken on your appeal by the Board of
Veterans' Appeals.